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    Easing the Discomfort of Colonoscopy


    "The sedation makes one feel light-headed," Glenn Eisen, MD, MPH, tells WebMD. Fortunately, the sedative that is used also causes amnesia, "so the patient may well not remember the procedure," he says. Patients having the procedure cannot be "put out" completely, as that would require a breathing machine, Eisen says, and that carries greater risks than the colonoscopy itself. Eisen is an associate professor of medicine and director of endoscopy at Vanderbilt University Medical Center in Nashville, Tenn.

    Ever since Today Show host Katie Couric televised her own colonoscopy, interest in the procedure has risen. However, colonoscopy isn't the only way to screen for this disease, and it may not be needed by everyone.

    Other screening methods for colon cancer include the fecal occult blood test (FOBT), a test that can detect microscopic amounts of blood in the stool; the flexible sigmoidoscopy ("flex sig"), which is much like the colonoscopy, but explores a smaller amount of the large intestine; and the double contrast barium enema, which uses dye inserted into the colon to make tumors, benign or cancerous, visible on X-ray.

    In previous research, Pignone found that the more informed patients are about the examinations and the disease, the more likely they are to get early screening. People need to know, he says, that "people over 50 are at risk, [and] screening can reduce cancer cases and deaths."

    According to the American Cancer Society, everyone should get an FOBT and a flexible sigmoidoscopy at age 50. If the results are normal, the FOBT should be repeated annually and the sigmoidoscopy every five years. Or, the patient could then have a colonoscopy (repeated every 10 years if normal) and/or a double-contrast barium enema (repeated every five to 10 years if normal)

    People at high risk for colon cancer, such as those with a family history of the disease, may need to start screening before age 50.

    Vital Information:

    • Colonoscopy is a procedure in which a flexible, lighted instrument is inserted into the anus to examine the colon. It usually requires sedation.
    • A new study shows that normal sedation is just as effective as patient-controlled sedation.
    • Colonoscopy is one of many tests that can be used to screen for colon cancer; others include the fecal occult blood test, flexible sigmoidoscopy, and contrast barium enema.
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